Single-Payer Will Be a Midterm Election Platform Issue

There is no doubt that healthcare will be a big part of the midterm election debate both at the federal and state level. Government efforts to undermine enrollment gains spawned by the Affordable Care Act (ACA) are working. A Kaiser Family Foundation study reports that individual enrollment fell by 12% in the first quarter of 2018 following a 12% decline last year. Pressure on the system continues to heat up – zeroing out the individual coverage mandate penalty and liberalizing short-term insurance coverage and association plan rules will provide further anti-selection and cost increases to the individual risk pools. Prices will once again soar. Notably, the coverage declines have been traced to individuals not receiving federal premium subsidies since costs have become unaffordable. No doubt that some of those opting out will experience the type of catastrophic uninsured costs of care which were highlighted in the buildup to ACA.

So it’s no surprise that this week, Forbes Magazine reported that a recent poll of likely voters showed that 57% of Americans want direct government involvement in providing healthcare. Single-payer will not be cheap, and the contradicting expert studies are being rolled out by both sides. One such study, funded by the ultra-right-leaning Koch Brothers, calculates the increase to government spending at $32.6 trillion dollars over 10 years, should a government-provided single-payer system be adopted (to put this in perspective the budget for all U.S. spending in 2017 was $4.1 trillion). On the other side, New York single-payer advocate Assemblyman Richard Gottfried has rolled out a RAND Corp. study which says single-payer would save New York State $15 billion or 3.1% by 2031. Adding to the pressure in New York, gubernatorial challenger and Sex and the City star, Cynthia Nixon, has made single-payer one of her platform positions.

Single-payer would be a very long, uphill climb. In order for a state to make a change, federal waivers would need to be granted for Medicaid and Medicare as well as the ACA subsidy program. With Republican control in Washington, this is unthinkable; with a shift in the political tide, it would still be near impossible. And, before the federal obstacles are cleared, the state hurdles are equally implausible. For the Federal Government to adopt single-payer the rules would have to be rewritten, an infrastructure created, and every participant in the healthcare ecosphere would be turned inside out. In the past, I have dismissed single-payer as impossible – and not just improbable. But, there is a ripple in the tea leaves. If the establishment doesn’t come up with some lasting wins – who knows?

About Craig Hasday

Craig Hasday is President of EPIC Northeast Benefits and President of Frenkel Benefits. As part of EPIC Insurance Brokers & Consultants (EPIC), Frenkel Benefits is one of the largest privately held independent employee benefits brokers in the United States.
Craig is a nationally recognized healthcare leader, who has sat on the national advisory boards of Aetna, UnitedHealthcare, Cigna and Anthem; as well as the regional advisory boards of most major carriers. He is currently on the MetLife and GeoBlue national advisory boards, is a legislative group member of the Council of Insurance Agents and Brokers and has been appointed to the MetLife National Broker & Consultant Summit. With current and former roles involved in lobbying and advisement on the legislative landscape, Craig is deeply engaged with the issues and intricacies surrounding healthcare delivery. He is an appointee to Governor Cuomo’s Regional Stakeholder Exchange Board and member of the NAHU Principals Council – as a liaison to the White House, U.S. Department of Health and Human Services (HHS), the U.S. Treasury and Congress – to advise on the practical issues associated with healthcare reform.
He has served as legislative chairperson for the New York State Association of Health Underwriters. Craig is also a former board member of the NAHU Education Foundation and has sat on the Global and Domestic Benefit Advisory Boards of Assurex Global. He is on the board of the NAHU Foundation and is a member of the UnitedHealthcare Children’s Foundation Regional Board of Directors.
Craig was honored with the International Benefits Network’s 2017 Service Excellence Award and selected as a 2015 Power Broker by Risk & Insurance Magazine. He is a frequent speaker on a broad array of issues affecting the insurance industry and is an adjunct professor in the New York University Masters of Human Capital Management Program.
Craig has appeared on CBS, NPR and other news programs as a healthcare commentator and is widely published and interviewed by the media as a benefits expert. As a judge for the 2014 and 2015 Business Insurance Benefit Manager of the Year awards, he contributes his benefits expertise toward selecting this prestigious award’s winner. Craig can be heard on WCBS Newsradio 880 during the daily business report speaking about healthcare and employer strategy in a segment titled, FrenkelySpeaking, which is based on the Frenkel Benefits’ blog.
Craig joined Frenkel in 1992, as the manager of what was then the Life & Employee Benefits department. Under his leadership, Frenkel Benefits has expanded almost twelvefold in revenue, now serving almost 800 clients across the U.S. and globally. Now together with EPIC, Frenkel Benefits is a significant contributor to EPIC’s benefits business.
Craig is a New York State CPA, formerly working in the New York office of a big-four accounting firm. He has experience as an audit and tax professional, chief financial officer and a small business owner. This diverse background brings an in-depth appreciation for the challenges facing clients.

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Please be aware that this does not represent legal or tax advice and is only Frenkel's interpretation of the laws, regulations and statutes. It is highly recommended that you seek the advice of your legal and tax professional as to the applicability of this information to your particular situation.